Provider Demographics
NPI:1760500854
Name:NASSAU COUNTY DEPT OF HEALTH
Entity Type:Organization
Organization Name:NASSAU COUNTY DEPT OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMISSIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:EISENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-571-2260
Mailing Address - Street 1:60 CHARLES LINDBERGH BLVD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-3683
Mailing Address - Country:US
Mailing Address - Phone:516-227-8609
Mailing Address - Fax:516-227-7079
Practice Address - Street 1:60 CHARLES LINDBERGH BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-3683
Practice Address - Country:US
Practice Address - Phone:516-227-8648
Practice Address - Fax:516-227-8662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
NY232437252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00337646Medicaid